Congenital Syphilis

If you are pregnant, talk to your healthcare provider about getting tested for the STD, syphilis, during your first and third trimesters to ensure your baby is not infected with congenital syphilis (CS). Up to 40 percent of babies born to women with untreated syphilis may be stillborn or die from the infection as a newborn, according to the Centers for Disease Control and Prevention (CDC). HIV and Syphilis Pregnancy Screening Law mandates that all pregnant women be tested for syphilis and HIV in the first and third trimesters of their pregnancy.

The following may occur if you have syphilis while pregnant:

• Miscarriage (losing the baby during pregnancy),
• Stillbirth (a baby born dead),
• Prematurity (a baby born early),
• Low birth weight or
• Death shortly after birth.

The following may occur if you give syphilis to your baby (congenital syphilis):

• Deformed bones,
• Severe anemia (low blood count),
• Enlarged liver and spleen,
• Jaundice (yellowing of the skin or eyes),
• Brain and nerve problems, like blindness or deafness,
• Meningitis and
• Skin rashes.

What is congenital syphilis?  

Congenital syphilis (CS) is a disease that occurs when a mother with syphilis -- a sexually transmitted infection that can cause serious health problems if not treated -- passes the infection on to her baby during pregnancy through the placenta. The infection can also be passed to the baby during labor and delivery. 

Syphilis can be treated.
Syphilis can be treated and cured with antibiotics. If you test positive for syphilis during pregnancy, be sure to get treatment right away. If you are diagnosed with and treated for syphilis, your doctor should do follow-up testing for at least one year to make sure that your treatment is working.

A baby born with CS can be treated.

There is treatment for CS. Babies who have CS need to be treated right away — or they can develop serious health problems. Depending on the results of your baby’s medical evaluation, he or she may need antibiotics in a hospital for 10 days. In some cases, only one injection of antibiotic is needed. It’s also important that babies treated for CS get follow-up care to make sure that the treatment worked.

All pregnant women should be tested for syphilis.

All pregnant women in Georgia should be tested for syphilis at the first prenatal visit (the first time you see your doctor for health care during pregnancy) and again during the third trimester of pregnancy. This is mandated by state law. 

Keep in mind that you can have syphilis and not know it. Many people with syphilis do not have any symptoms. Also, syphilis symptoms may be very mild or similar to signs of other health problems. The only way to know for sure if you have syphilis is to get tested.

Get a syphilis test at your first prenatal visit.

If you are pregnant, and have syphilis, you can still reduce the risk of CS in your baby. Getting tested and treated for syphilis can prevent serious health complications in both mother and baby.

Prenatal care is essential to the overall health and wellness of you and your unborn child. The sooner you begin receiving medical care during pregnancy, the better the health outcomes will be for you and your unborn baby.

At your first prenatal visit, ask your doctor about getting tested for syphilis. It is important that you have an open and honest conversation with your doctor at this time about your sexual history and about STD testing. Discuss any new or unusual physical symptoms you may be experiencing, as well as any drugs/medicines you are using, and whether you have new or multiple sex partners. This information will allow your doctor to make the appropriate testing recommendations. Even if you have been tested for syphilis in the past, you should be tested again when you become pregnant.

If you test positive for syphilis, you will need to be treated right away. Do not wait for your next prenatal visit. It is also important that your sex partner(s) receive treatment. Having syphilis once does not protect you from getting it again. Even after you’ve been successfully treated, you can still be re-infected. For this reason, you must continue to take actions that will reduce your risk of getting a new infection.

Reduce your risk of getting syphilis before and during your pregnancy.

Preventing syphilis in women and their sex partners is the best way to prevent CS.

If you are sexually active, the following things can lower your chances of getting syphilis:

• Being in a long-term mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis.
• Using latex condoms the right way every time you have sex. Although condoms can prevent transmission of syphilis by preventing contact with a sore, you should know that sometimes syphilis sores occur in areas not covered by a condom, and contact with these sores can still transmit syphilis.

Also, talk with your doctor about your risk for syphilis. Your doctor can give you the best advice on any testing and treatment that you may need.

Remember that it’s possible to get syphilis and not know it, because sometimes the infection causes no symptoms, only very mild symptoms, or symptoms that mimic other illnesses.

How can I reduce the risk of my baby getting CS or having health problems associated with CS?

Your baby will not get CS if you do not have syphilis. There are three important things you can do to protect your baby from getting CS and the health problems associated with the infection:

• Get a syphilis test at your first prenatal visit.
• Get a syphilis test at your third trimester visit.
• Reduce your risk of getting syphilis before and during your pregnancy.

The HIV and Syphilis Pregnancy Screening Law (§31-17-4.2.) mandates that all pregnant women be tested for syphilis and HIV in the first and third trimesters of their pregnancy.

Key points of the law: 

• Every physician and health care provider who provides prenatal care must test pregnant women for syphilis and HIV at initiation of prenatal care and during the third trimester, unless the patient declines (opt-out screening).
• If there is no written evidence that an HIV or syphilis test has been performed when a pregnant woman presents for delivery, the health care provider must order a test for both to be administered at that time, unless the patient declines.
• All congenital syphilis cases must be reported within 24 hours to your local district health office or entered in the State Electronic Notifiable Disease Surveillance System (SendSS). This includes babies without congenital syphilis symptoms who were born to mothers with untreated syphilis at time of delivery.
• All babies born to HIV positive mothers and women diagnosed with HIV or AIDS must be reported within seven days to the Georgia Department of Public Health.

Syphilis treatment at least 30 days before birth has proven effective at decreasing the chances a baby is born with congenital syphilis. HIV antiretroviral therapy during pregnancy, at the time of delivery, and prophylaxis to the newborn, dramatically reduce perinatal transmission of HIV.

Providers should make the first and third trimester testing for syphilis and HIV part of their routine prenatal care – because it is the law and for the health and well-being of every mother and child in Georgia.

For additional information about mandatory testing, please contact your local district health office or call the Georgia Department of Public Health at 1-866-PUB-HLTH (1-866-782-4584). You can schedule testing for syphilis and HIV by calling the Georgia AIDS and STD information line for assistance at: 1-800-551-2728.

Where can I get more information?

STD information and referrals to STD Clinics
CDC-INFO
1-800-CDC-INFO (800-232-4636)
TTY: 1-888-232-6348
In English, en Español

CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
E-mail: npin-info@cdc.gov

American Sexual Health Association (ASHA)
P. O. Box 13827
Research Triangle Park, NC 27709-3827
1-800-783-9877

*This webpage was developed using information provided by the Centers for Disease Control and Prevention (CDC). 

Page last updated 12/06/2018